Exam 1 Evidence-Based Medicine with
Complete Solutions
What is the definition of evidence-based medicine (EBM) that many people had a
problem with? - correct answer-The conscientious, explicit, and judicious use of current
best evidence in making decisions about the care of individual patients
What is evidence-based medicine? - correct answer-The integration of best research
evidence with clinical expertise and patient values
Why should one practice evidence-based medicine? - correct answer-Relying on
primary knowledge results in overestimate efficacy and underestimate risks
Variation in clinical services, such as inappropriate care, lack of care, increased costs
What are the sources of knowledge in medicine? - correct answer-1. Reference to
tradition (what we have been doing)
2. Reference to authority
3. Trial and error
4. Logical reasoning
5. Scientific method
What is the scientific method? - correct answer-Observation
Research
Hypothesis
Experiment
Data
Conclusion
What is the problem with relying on sources of knowledge? - correct answer-Practice
continues to rely on sources of knowledge other than the scientific method
- Gap between new research findings and incorporation into practice
What are the 5 "As" of evidence based medicine (EBM)? - correct answer-1. Ask -
develop answerable questions
2. Acquire - gather the evidence
3. Appraise - evaluate the evidence
4. Apply - incorporate evidence into clinical decision
5. Assess - reflect on how well the process worked and how to improve for next time
What are PICO questions? - correct answer-Patient, intervention, comparison, outcome
, What are the four parts to developing a clinical question? - correct answer-PICO
- The patient or problem being addresses
- The intervention or exposure being considered
- The comparison intervention or exposures when relevent
- The clinical outcome or outcomes of interest
What are the function of background questions? - correct answer-- Covers the more
basic scientific concepts
- Does not refer to a particular patient situation
- Can be answered using tertiary resources
What are the functions of foreground questions? - correct answer-- Covers how these
concepts are applied to an individual patient's circumstance
- Must have adequate background knowledge to ask and answer these questions
What would be a PICO question for the following scenario?
JL is a 70 year old man with type 2 diabetes mellitus (DM) presenting for a prescription
refill for HCTZ.
JL tells you that his doctor suggested switching his BP medication from HCTZ to
lisinopril to better protect his kidneys from damage related to type 2 DM.
JL is reluctant to make this change because his friend has a "bad reaction" to lisinopril.
He would like to know what you think about his doctor's suggestion. - correct answer-
PICO:
P: 70 y/o man with Type 2 DM
I: Lisinopril
C: HCTZ
O: Kidney Protection
In elderly patients with Type 2 DM, does Lisinopril provide superior kidney protection
compared to HCTZ?
What are some classifications of questions? - correct answer-- Therapy or prevention
- Etiology or harm
- Prognosis
- Diagnosis
- Economic impact
What is the hierarchy of evidence for acquiring information? - correct answer-1.
Systematic Reviews/Meta-analyses
2. Randomized trials
3. Cohort studies
Complete Solutions
What is the definition of evidence-based medicine (EBM) that many people had a
problem with? - correct answer-The conscientious, explicit, and judicious use of current
best evidence in making decisions about the care of individual patients
What is evidence-based medicine? - correct answer-The integration of best research
evidence with clinical expertise and patient values
Why should one practice evidence-based medicine? - correct answer-Relying on
primary knowledge results in overestimate efficacy and underestimate risks
Variation in clinical services, such as inappropriate care, lack of care, increased costs
What are the sources of knowledge in medicine? - correct answer-1. Reference to
tradition (what we have been doing)
2. Reference to authority
3. Trial and error
4. Logical reasoning
5. Scientific method
What is the scientific method? - correct answer-Observation
Research
Hypothesis
Experiment
Data
Conclusion
What is the problem with relying on sources of knowledge? - correct answer-Practice
continues to rely on sources of knowledge other than the scientific method
- Gap between new research findings and incorporation into practice
What are the 5 "As" of evidence based medicine (EBM)? - correct answer-1. Ask -
develop answerable questions
2. Acquire - gather the evidence
3. Appraise - evaluate the evidence
4. Apply - incorporate evidence into clinical decision
5. Assess - reflect on how well the process worked and how to improve for next time
What are PICO questions? - correct answer-Patient, intervention, comparison, outcome
, What are the four parts to developing a clinical question? - correct answer-PICO
- The patient or problem being addresses
- The intervention or exposure being considered
- The comparison intervention or exposures when relevent
- The clinical outcome or outcomes of interest
What are the function of background questions? - correct answer-- Covers the more
basic scientific concepts
- Does not refer to a particular patient situation
- Can be answered using tertiary resources
What are the functions of foreground questions? - correct answer-- Covers how these
concepts are applied to an individual patient's circumstance
- Must have adequate background knowledge to ask and answer these questions
What would be a PICO question for the following scenario?
JL is a 70 year old man with type 2 diabetes mellitus (DM) presenting for a prescription
refill for HCTZ.
JL tells you that his doctor suggested switching his BP medication from HCTZ to
lisinopril to better protect his kidneys from damage related to type 2 DM.
JL is reluctant to make this change because his friend has a "bad reaction" to lisinopril.
He would like to know what you think about his doctor's suggestion. - correct answer-
PICO:
P: 70 y/o man with Type 2 DM
I: Lisinopril
C: HCTZ
O: Kidney Protection
In elderly patients with Type 2 DM, does Lisinopril provide superior kidney protection
compared to HCTZ?
What are some classifications of questions? - correct answer-- Therapy or prevention
- Etiology or harm
- Prognosis
- Diagnosis
- Economic impact
What is the hierarchy of evidence for acquiring information? - correct answer-1.
Systematic Reviews/Meta-analyses
2. Randomized trials
3. Cohort studies
